NHB

NAME OF THE TRAINING *

NAME OF THE ORGANIZATION *

NAME OF THE PARTICIPANT*

DESIGNATION *

EDUCATIONAL QUALIFICATION *

AREAS OF RESPONSIBILITIES / DUTIES *

EXPERIENCE (Number Of Years / Months) *

OFFICIAL ADDRESS *

TELEPHONE NO *

FAX NO

MOBILE NO*

EMAIL ID *

TICK WHICHEVER IS APPLICABLE *

RESIDENTIAL

NON RESIDENTIAL

DATE OF FUND TRANSFER: *

UIN CODE *

Nomination Fee (ELECTRONIC PAYMENT ONLY) • Residential: Rs. 10,000.00 (Rupees Ten Thousand) only • Non Residential: Rs. 8,000.00 (Rupees Eight Thousand) only • Nomination fee is inclusive of 12.36% service tax

Details of Remittance given below:
Name of Account same as in the Bank Name of the Bank Name of the Branch Address of the Branch	NATIONAL HOUSING BANK ICICI BANK LIMITED NEW DELHI – CONNAUGHT PLACE 9A, PHELPS BUILDING, INNER CIRCLE ,CONNAUGHT PLACE, NEW DELHI – 110001
Account No.	000705001504
Account Type	CURRENT
MICR Code.	110229002
IFSC Code of the Bank Branch	ICIC0000007